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Making IT Meaningful

Commissioned by the National Partnership, developed by research partner Professor Alan Westin, Ph.D. and conducted by Harris Interactive, the online survey of nearly 2,000 respondents, with an oversample of Hispanic adults, details consumer experiences with both electronic and paper medical record systems. Intended to serve as a baseline for future studies, the survey looks at how consumers value electronic vs. paper records, how concerned they are about data breaches, and whether they trust electronic medical records more or less than paper records to protect their privacy. It is designed to amplify consumers' voices and inform implementation of health IT.

Making IT Meaningful

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Methodology Conducted online survey within U.S. August 3-22, 2011 Total respondent pool of 1,961 adults who: Have ongoing relationship with a care provider Know what kind of record system—electronic or paper—this provider uses(Sample represents about 56% of all U.S. adults) Sample weighted to be demographically representative of adult U.S. population, and to account for bias inherent in online surveys 58.8% (1,153) in EHR systems; 41.2% (808) in paper systems Survey also offered in Spanish; conducted an over-sampling of Hispanic respondents (n=227) 2

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Online Access IncreasesPerceptions of Value and Trust Among the 26% of EHR respondents with online access to their health information, respondents are more likely to say: EHR is useful to them personally for key elements of care (understand condition, keep up with medications, maintain healthy lifestyle, etc.) EHR has a positive impact on quality of care EHRs are useful to their provider (correcting errors records, avoid medical errors, etc.) They trust their provider to protect patient rights They are well informed by their provider about how medical information is collected and used Hispanic respondents with online access are more likely (+15%) to say it increases their desire to do something to improve their health 2/3 of paper respondents want online access, and even more Hispanic adults in paper systems do – close to 3/4 6

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Patients Generally Trust EHRsMore Than Paper Records Both groups of respondents rated EHRs higher than paper systems in complying with patients’ rights and enhancing elements of privacy These rights/elements include: Giving patients confidence information is safe Complying with privacy laws/rules Giving patients more control over to whom info is disclosed for purposes beyond direct care Allowing patients to see a record of who has had access to their info Helping patients earn trust in how information is handled 7

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Detailed Privacy Analysis Created a “Privacy Segmentation” to: Identify segments of population most and least worried about health IT privacy Understand what demographic sub-groups make up each segment Explore relationship between trust and value 9

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Who are the Most Privacy Worried? Among EHR respondents: Men Those earning less than $35K a year Those aged 35-46 Those living in the South Among paper respondents: Men College educated Those aged 35-46 Those living in East or West Those with sensitive health conditions were evenly distributed across all segments

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There is a Relationship BetweenPrivacy Concerns and PerceivedValue of EHRs Compared to the “worried,” EHR respondents who are more comfortable with privacy issues are: 25% higher in saying the EHR has had a positive impact on the quality of their care 33% higher in saying the system is useful in complying with privacy/confidentiality laws and regs 9% higher in saying they are satisfied with their record system Similar results among “Comfortable” paper respondents 12

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Consumers Want Doctors toUse EHRs 3 out of 4 paper respondents say it would be valuable if their doctor adopted an EHR EHRs far outpace paper in perceived impact on overall quality of care 73% of EHR respondents say their doctor’s use of an EHR has a positive impact on quality of care Compared to only 26% of paper respondents 13

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Key Policy Recommendations To make the survey actionable, we provided Policy Recommendations Three main categories: Consumer education/engagement campaigns Functional and privacy requirements for the Meaningful Use program Guidance for broader federal programs (Accountable Care Organizations, Medical Homes, etc.) 14